Provider Demographics
NPI:1497633564
Name:LAMARRE, KETLYNE (STUDENT)
Entity type:Individual
Prefix:MS
First Name:KETLYNE
Middle Name:
Last Name:LAMARRE
Suffix:
Gender:F
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8824 MERRICK BLVD APT 4N
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4118
Mailing Address - Country:US
Mailing Address - Phone:718-350-1495
Mailing Address - Fax:
Practice Address - Street 1:3427 STEINWAY ST STE 301
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-8602
Practice Address - Country:US
Practice Address - Phone:718-712-3358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator